Integrated Pathways to Healthy Ageing (PHA): A Conceptual Ecosystem

Background: Ageing is commonly accompanied by an associated increase in the prevalence of chronic musculoskeletal, metabolic and mental health conditions that affects physical capacity and overall decline in quality of life. To date, most health interventions have been monodisciplinary and monomodal, with a relatively narrow focus and loci of impact. What is now being advocated is more interdisciplinary health promotion measures for the attainment of healthy ageing. This paper reports on an empirical intervention designed to integrate chiropractic and osteopathic services with medical and physiotherapy services in an Australian Residential Aged Care facility. It replaces the traditional cause-effect linear focus with a conceptual ecosystem and identifies an action framework to underpin the design of effective actions to facilitate Integrated Pathways to Healthy Ageing. Methods: A qualitative multi-method research approach was chosen that included a case study of a real-time intervention, utilising a modified action research methodology combined with interpretive data analysis. This enabled the experience of change to be planned and actioned while, at the same time, being observed and reflected by a project team established for this purpose. The interpretive analysis by the project team members was based on a conceptual ecosystem based on six tenets of a distributed leadership, collaborative and participative, leadership approach. Results: The findings confirmed the applicability of the six tenets of the conceptual ecosystem for an integrated approach to aged health care. This led to the formulation of a holistic approach termed a Conceptual Ecosystem of Integrated Pathways to Healthy Ageing together with a conceptual Ecosystem Action Framework. Conclusions: The paper concludes that the conceptual Ecosystem can be used to effectively integrate chiropractic and osteopathic services with medical and physiotherapy services to action more holistic, synergistic Integrated Pathways to Healthy Ageing. While further research is required, the authors propose that the conceptual ecosystem and associated action framework can form the basis of actions needed to develop more collaborative approaches to integrate a greater range of health services into multi-disciplinary, multi modal pathways to healthy ageing.